Endoscopy 2025; 57(S 02): S280
DOI: 10.1055/s-0045-1805681
Abstracts | ESGE Days 2025
ePosters

Financial study of endoscopic band ligation without resection (with SINK biopsy) application in≤10-mm digestive tract subepithelial tumors: exponential cost-effective strategy

Authors

  • F Bas-Cutrina

    1   Servei d’Aparell Digestiu, Hospital General de Granollers, Granollers, Spain
    2   Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
    3   Unitat d’Endoscòpia, Servei d’Aparell Digestiu, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain

  • S Maisterra-Santos

    3   Unitat d’Endoscòpia, Servei d’Aparell Digestiu, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
    4   Universitat de Barcelona, Barcelona, Spain
    5   Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain

  • C Loras

    6   Servei d’Aparell Digestiu, Hospital Universitari Mútua Terrassa, Terrassa, Spain
    7   Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain

  • A Pardo

    8   Servei d’Aparell Digestiu, Hospital Universitari Joan XXIII de Tarragona, Tarragona, Spain

  • R Ballester-Clau

    9   Servei d’Aparell Digestiu, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain

  • F González-Huix

    9   Servei d’Aparell Digestiu, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain

  • C Huertas

    10   Servei d’Aparell Digestiu, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain

  • C Guarner-Argente

    11   Unitat d’Endoscòpia, Servei d’Aparell Digestiu, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

  • J Colan-Hernandez

    12   Unitat d’Endoscòpia, Servei d’Aparell Digestiu, Hospital Universitari Germans Trias i Pujol, Badalona, Spain

  • T Carnaval

    13   Servei de Farmacologia Clínica, Hospital Universitari Germans Trias i Pujol, Badalona, Spain

  • S Videla

    13   Servei de Farmacologia Clínica, Hospital Universitari Germans Trias i Pujol, Badalona, Spain

  • J B Gornals

    3   Unitat d’Endoscòpia, Servei d’Aparell Digestiu, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
    4   Universitat de Barcelona, Barcelona, Spain
    5   Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
Further Information
Also available at
 

Aims Small subepithelial tumours (SET) require endoscopic surveillance. PMID 37263361 study revealed that endoscopic band ligation without resection (EBL), combined with single-incision needle-knife (SINK) biopsy, led to a change in clinical management in 92.7% of≤10-mm SETs. Aims: to assess the financial impact EBL+SINK strategy implementation would offer through a cost comparison analysis, as well as the impact on the number of annual procedures to be performed (EFI-BANDING-SET study).

Methods Comparison of the conventional management strategy for SETs≤10-mm (with endoscopic surveillance every two years: alternating conventional upper digestive endoscopy [UGE] at the 1st-3rd-5th, etc... controls with endoscopic ultrasonography [EUS] at 2nd-4th-6th, etc… procedures) vs. the proposed EBL+SINK strategy. Fees for endoscopic procedures have been referred from PMID 29610018, updated to 2024 according to the evolution of the Spanish Gross National Product (2018–>2024:+19.2%).

Results Procedural amounts: UGE €100.74; EUS €360.70; EBL+SINK €777.57 (taking into account an adverse event rate of 4.9% [reported in PMID 37263361]). Model assumption: continuous inclusion of one nonspecific≤10-mm SET each year, in≤65 years patient. For each≤10-mm SET with the proposed strategy application (EBL+SINK), compared to the conventional endoscopic follow-up strategy (UGE/EUS every 2 years): from the 2nd direct year onwards, and the 3rd global-cumulative, there is a savings in the number of endoscopic procedures to be performed, with the trend of exponential evolution (5th year: -1.76 procedures; 10th year: -14.11 procedures; 15th year: -38.59 procedures). From the 6th direct year, and the 11th global-cumulative, the direct costs between strategies are beneficiaries, with the subsequent trend being of exponential progressive savings (5th year:+€1,685.51; 10th year: + €857.81; 15th year: -€2,636.65).

Conclusions EBL combined with SINK biopsy in≤10-mm SETs entails, from the 2nd direct year, and the 3rd global-cumulative, an exponential reduction in the number of endoscopic procedures to be performed annually. The strategy is cost-effective, with a progressive savings of direct resources from year 6 onwards, and from 11th global-cumulative year [1] [2].



Publication History

Article published online:
27 March 2025

© 2025. European Society of Gastrointestinal Endoscopy. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

  • References

  • 1 Bas-Cutrina F, Loras C, Pardo A, Ballester-Clau R, Huertas C, Guarner-Argente C. et al. Management of small subepithelial tumors by endoscopic banding without resection and single-incision needle-knife-assisted biopsy sampling: a prospective multicenter study. Gastrointest Endosc 2023; 98: 911-21
    CrossrefPubMedSearch in Google Scholar
  • 2 Loras C, Mayor V, Fernández-Bañares F, Esteve M.. Study of the standard direct costs of various techniques of advanced endoscopy. Comparison with surgical alternatives. Dig Liver Dis 2018; 50: 689-97
    CrossrefPubMedSearch in Google Scholar